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Medical History and Physical Exam for HIV Infection

Exam Overview

When you are first diagnosed with
HIV, your doctor will check your current health
status. He or she will ask questions about your current symptoms and past
health to find out whether you have had any HIV-related illnesses, whether you
have medicine allergies, whether your immunizations are up-to-date, and whether
you have ever been hospitalized for illness or surgery.

Many of
the tests a doctor does during the initial exam will be repeated during regular
checkups to monitor changes in your health.

Medical history

You can help your doctor diagnose
and treat your condition by being prepared to answer the following
questions:

Do you have an increased risk for developing
HIV? You have an increased risk of developing HIV if you:

Are a man who has sex with
men.

Have more than one sex partner, especially if one of you
injects drugs.

Inject drugs or steroids, especially if you share
needles, syringes, cookers, or other equipment used to inject drugs.

Have high-risk partner(s) (a man or woman who has multiple sex
partners or injects drugs, or a man who has sex with men).

Have you ever had symptoms that might indicate illness, such as
fever, weight loss, shortness of breath, or diarrhea?

Have you ever
had
tuberculosis, fungal or yeast infections, liver
infection (hepatitis), cold sores (oral
herpes), or any other sexually transmitted diseases?
All of these diseases can present special problems for people who are infected
with HIV.

Are you a caregiver, such as a partner or parent, of a
person who is HIV-positive and has
hemophilia?

Physical exam

Your doctor will do a complete
physical exam to find out your present state of health. This may include the
following exams:

Temperature. Fevers are common in people who have HIV, even when no other
symptoms are present. Fever can sometimes be a sign of a certain kind of
infection or cancer that is more common in people who
have weakened
immune systems.

Weight. Your doctor will weigh you at every
visit. A loss of 10% or more of your body weight may be a result of wasting
syndrome, which is one of the signs of
AIDS, the last and most severe stage of HIV infection.
You may need help getting adequate nutrition if you have lost weight.

Eyes. Cytomegalovirus (CMV) retinitis is a
common complication of AIDS. It occurs more frequently in people who have a
CD4+ cell count of less than 100 cells per microliter
(mcL). Symptoms include seeing floaters, blurred vision, or loss of vision. If
you have symptoms of CMV retinitis, you should see an
ophthalmologist as soon as possible. Some doctors
recommend ophthalmologist visits every 3 to 6 months if your CD4+ cell count is
less than 100 cells per microliter (mcL).

Mouth. Oral yeast infections (thrush) and other mouth sores are very common in
people who are HIV-infected. You should have a dental exam at least twice a year. If you develop
symptoms of gum disease (periodontal disease), you may need to see your dentist
more often.

Lymph nodes. Lymph node enlargement
(lymphadenopathy) is not always caused by HIV alone. A
biopsy may be considered if your
lymph nodes are getting larger or if some are
different sizes (asymmetrical).

Abdomen. The abdominal exam may show an enlarged
liver (hepatomegaly) or enlarged spleen (splenomegaly). These conditions can be
caused by new infections or may indicate cancer. Your doctor will do an
abdominal exam if you develop symptoms such as pain in the
upper right or upper left part of your abdomen.

Gynecologic. Women who are HIV-infected have
more
cervical cell abnormalities than women who do not have
HIV. These cell changes can be detected with a
Pap test. You should have two Pap tests during the
first year after you have been diagnosed with HIV. If the first two Pap tests
are normal, you should have a Pap test once a year. You may need to have a Pap
test more frequently if you ever have an abnormal test result.

Why It Is Done

The medical history and physical exam are done right
after a person has been diagnosed with HIV infection (2 positive
ELISA tests and 1 positive
Western blot assay).

A thorough physical exam will
provide information about your present state of health. Your doctor will talk to you about the benefits and risks of starting treatment for HIV.

During later visits,
your doctor will do tests, such as viral load and CD4+ cell count, to see whether your health status is
changing.

These exams will be
done during regular follow-up exams or if specific symptoms develop.

Results

The medical history and physical exam may
provide the following results.

Normal

No abnormalities are found. After the initial workup, talk
to your doctor to decide how often to schedule follow-up exams.

The frequency of follow-up exams depends on
whether you have symptoms of illness and your initial
viral load and
CD4+ cell count measurements.

Follow-up
exams may be done as often as every 3 to 6 months, possibly more often,
especially right after you start medicine treatment.

If you do not have symptoms but you have a high CD4+ cell
count and a low viral load, your doctor will probably recommend that you have
follow-up exams at least every 6 months or sooner if you develop symptoms of
illness.

Abnormal

Signs of illness are found. Follow-up and treatment will
depend on the specific problem.

What To Think About

Your family medicine physician or
internist may not be able to diagnose and treat all the problems that can be
caused by HIV infection. Your doctor may refer you to another doctor who
specializes in conditions that affect different body systems. Before you make
an appointment with a specialist, find out whether he or she has experience
treating people who have HIV-related illnesses.

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use.